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Placental Syncytiotrophoblast Maintains a Specific Type of Glycocalyx at the Fetomaternal Border: The Glycocalyx at the Fetomaternal Interface in Healthy Women and Patients With HELLP Syndrome

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Abstract

Recent studies showed that considerable amounts of glycosaminoglycans are released into maternal blood during normal pregnancy and in hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. Maternal endothelia and the syncytiotrophoblast layer have been discussed as a possible origin of these glycocalyx components. Our study aimed to visualize the glycocalyx on the syncytiotrophoblast by electron microscopy, to analyze its structure and composition by immunohistochemistry, and to determine potential differences between healthy women and women with HELLP syndrome. For electron microscopy, a cotyledon was fixed by perfusion of the intervillous space with a 2% lanthanum–nitrate glutaraldehyde solution followed by immersion fixation in the same fixative. For immunohistochemistry, sections of 16 placentas (HELLP patients/healthy women, n = 8 each) were stained with monoclonal antibodies against the main glycocalyx constituents syndecan 1, hyaluronic acid, and heparan sulfate. Semiquantitative evaluation of staining intensity focused on the apical surface of the syncytiotrophoblast and fetal intravillous endothelia as possible localizations of a placental glycocalyx. Electron microscopy revealed a glycocalyx of approximately 250 nm, covering the syncytiotrophoblast layer. This was found to contain large amounts of syndecan 1, but neither hyaluronic acid nor heparan sulfate as major components. Intravillous fetal endothelium did not express any of the investigated glycosaminoglycans. Healthy women and patients with HELLP showed no differences concerning glycocalyx composition and thickness of the syncytiotrophoblast. The composition of the “placental” glycocalyx differs from the adult and fetal vascular glycocalyx. Obviously, the human placental syncytiotrophoblast maintains a special kind of glycocalyx at the fetomaternal interface.

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Authors and Affiliations

  1. Clinic of Anesthesiology, Ludwig-Maximilians University, Munich, Germany

    Klaus F. Hofmann-Kiefer MD, D. Chappell MD, N. Martinoff MD, P. Conzen MD & M. Rehm MD

  2. Clinic of Gynecology and Obstetrics, Ludwig-Maximilians University, Munich, Germany

    J. Knabl MD

  3. Institute of Histology and Microscopic Anatomy, Ludwig-Maximilians University, Munich, Germany

    H. G. Frank MD

  4. Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians University, Munich, Germany

    B. F. Becker MD

  5. Klinik für Anaesthesiologie der Ludwig-Maximilians-Universität München, Klinikum Innenstadt, Maistr.11, 80337, München, Germany

    Klaus F. Hofmann-Kiefer MD

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  1. Klaus F. Hofmann-Kiefer MD
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  2. D. Chappell MD
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  3. J. Knabl MD
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  4. H. G. Frank MD
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  5. N. Martinoff MD
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  7. B. F. Becker MD
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Correspondence to Klaus F. Hofmann-Kiefer MD.

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Hofmann-Kiefer, K.F., Chappell, D., Knabl, J. et al. Placental Syncytiotrophoblast Maintains a Specific Type of Glycocalyx at the Fetomaternal Border: The Glycocalyx at the Fetomaternal Interface in Healthy Women and Patients With HELLP Syndrome. Reprod. Sci. 20, 1237–1245 (2013). https://doi.org/10.1177/1933719113483011

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  • DOI: https://doi.org/10.1177/1933719113483011

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